直线法乳房成形术的临床应用

目的介绍直线法乳房成形术(Lejour法)及其改进方法。方法按Lejour法设计手术切口,剥离乳腺组织,仅保留上部蒂营养乳头、乳晕,去除部分肥大下部及基底乳腺组织,将剩余腺体组织的乳腺基底层固定于第2、3肋水平。重新塑形乳腺组织,皮肤无张力缝合。对于部分乳房肥大明显患者可以首先抽吸脂肪,主要减少乳房腺体内、外侧及侧胸部皮下脂肪。结果采用此法矫治巨乳症、单纯乳房下垂共48例,其中辅助脂肪抽吸13例,术后乳房外形美观,术后3个月随访,3例有修整乳晕瘢痕或乳房下皱襞瘢痕。结论本术式简便易行,且远期效果好,乳房外形挺拔,可作为乳房缩小悬吊术的可行术式之一。

Clinical application of vertical mammaplasty for breast hypertrophy and ptosis

Objective To introduce an improved technique of vertical mammaplasty that was first reported by Madeleine Lejour in Brussels. Methods Vertical mammaplasty is a technique that uses adjustable markings, an upper pedicle for the areola, and a central breast reduction with lower skin undermining. The shape of the breast was created by suturing the gland and did not rely on the skin. No scar was produced in submammary fold. Liposuction was added whenever feasible. Results 48 cases were treated with vertical mammaplasty in our department since 1999. Reduction of volume was from 120g to 780g per side, and liposuction was added in 13 cases. The shape of the new breast was satisfactory in all patients after 3-12 months following-up. Areora necrosis was not found in all cases. But the vertical hypertrophic scar displayed in three cases that required a scar revision. Conclusions The vertical mammaplasty is an optical technique for moderate macromastia and breast ptosis. Stable results are produced because the gland is strongly sutured. Few postoperative complications occur after experiencing several cases.